how come understanding and impact is so challenging for human · preoccupied: confused state of...
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How come understanding and intervening with attachment and its impact is so challenging for human service professionals and families?
“Neurons that fire together, Wire Together” (Siegel, 2004)
Mirror Neurons: “smart brain cells” that explain how we connect and relate to each other
From birth hardwired to detect sequences and make maps in our brains of the internal state, intentional stance of other people.
Our behavior sequencing circuits are initially dependent on parents. (What we expect from others)
IF: Caregivers Straightforward: Map sequences with security embedding intentions in kindness and care
IF: Caregivers are confusing and hard to read our sequencing map of behavior are likely to be distorted.
First Mind is the Internal State of Our Caregiver: Know ourselves as reflected in our caregivers first.
Then through a process of development we develop separate self.
Recent Research: Released when we feel close and attached to someone. Children in orphanages had lower rates of oxytocin than control group.
What happens without the chemical?
Both mother and infant contribute to the attachment process
The parent-child relationship shapes children’s:
Peer relationships (concept of “first friend”)
Sense of security re exploring the world
Resilience to stress
Ability to regulate emotions
Capacity to carry a coherent story that makes sense of their lives
Future interpersonal relationships
The Process
Key Factor: Reunion with mother
How child greeted mother after separation?
How easily distressed was soothed?
How rapidly returned to play with toys?
Those who were securely attached:
Sensitive to the child’s bids for connection
Could read child signals
Effectively meet needs
Insecurely attached:
Parent did not respond to child’s signals
Seemingly indifferent to child’s distress
In order to cope “child minimizes activation of attachment circuitry”
Insecure Attachment:
80% of high risk groups such as drug addicted parents
Child may look terrorized upon absence, but then approaches but then withdraws,
Freezes, fall down on the floor, clings and cries while simultaneously pulling away
Insecure Attachment: Disorganized
Sometimes were sensitive and others times not
Wary of separation, not easily soothed upon reunion, does not readily return to toys, may cling to parent
Contact with the parent does not bring relief
Insecure Attachment: Disorganized
Parents sow severe terrifying lack of attunement when child is frightened of them
Healthy
Secure
Insecure
Disorganized
RAD
Child cannot find an effective means to cope
Brain does not experience an integration of energy and information as in the secure attachment
Rather disrupted flow
Rigidity Avoidance
Chaos Ambivalence
Vacillation between the two extremes: Disorganized
Brain-stem
Diencephalon
Limbic
NeocortexAbstract ThoughtConcrete ThoughtExecutive FunctionAttachmentSexual BehaviorEmotional RegulationMotor RegulationMotivationArousalSleepBP / Heart RateRespiratory DriveBody TemperaturePerry 2006
All sensory input enters here
Brain-stem
Diencephalon
Limbic
Neocortex
Complexity Plasticity &Ease of change
Attachment: Primarily Limbic Region Development
Good bodily regulation
Emotional balance
Response flexibility
Fear modulation
Empathy and Insight
Brain Development in Insecure Attachment
Anxiety
Insecurity
Inability to relate to others
Inability to regulate emotions
Many symptoms of dissociation
Heighted risk for PTSD
Earlier the trauma and the closer the relationship with the perpetrator of the trauma, the more impactful the experience is on the child’s development (Walker, 2007)
More likely that the child will experience betrayal trauma (Freyd, 1994; Goldberg & Freyd, 2004).
“predicts that the degree to which a negative event represents a betrayal by a trusted, needed other will influence the way in which that even is processed and remembered” (Sivers, Schooler, & Freyd, 2002).
Research: Best Predictor of Child’s Security of Attachment is not what happened to the child’s parents but how the parents made sense of their childhood experiences.
Asking right questions can help us understand how they made sense of their past
How mind made sense of their experiences predicted the attachment style that their child had
Securely attached:
Most often acknowledged both positive and negative aspects of their family experiences
Show how their experiences related to their later development
Had coherent account of their past and who they were
Secure Attached: Even if difficult childhood had:
A relationship with a person attune to them
Helped build experience of wholeness
Able to reflect on ways that help them make sense of their experiences
Called “Earned Secure” Life Narrative
Dismissing Mind (Avoidant as Child)
Left side dominant (factual) versus Right side autobiographical details (relationships)
Minimization of the need for others
Left adaptation so as not to feel the pain of missed connections
Integration of right hemisphere. Feelings become more available
Preoccupied: Confused state of self
Inability due to ambivalent attachment to develop sense of self (fears of abandonment)
I need others but I cannot depend on them
Inability to become differentiated from parent affects adult relatedness of not being able to see the other as separate (Hyperarousal of A.S.)
Understanding the origins to integrate left side with the dominant right (
Disorganized: Fear without solution
Child self becomes fragmented
Often result of unresolved trauma and dissociation and betrayal
Specific triggers create an exaggerated survival response
Bringing terrified right hemisphere images into relationship with left brain ability to understand them; Developing a narrative
Study in England of adoptive children between the ages of 3 and 7.
The adult attachment style predicts the child’s ability to attach and the decrease of behavioral challenges.
Coherent Narrative relationship with self
Curiosity
Openness
Acceptance
Have the ability to feel other people
Insecurely attached:
Challenging childhood often resulted in incoherent account of
Recognition that fear due to unresolved early childhood trauma may curtail parents conscious deployment of attention to infants fear signals to avoid their own retriggering
Van der Kolk: “The earliest and possibly most damaging psychological trauma is the loss of a secure base.”
Parent becomes source of protection and also represent harm
“fear without solution”
“caught between approach and avoidance”
“intractable emotional dilemma
“source of solution and source of alarm”
“parent as traumatic reminder”
82% maltreated youth have serious disturbances in their attachment to caregivers
Recognizing impact to neurodevelopment, perception of others, and perception of self
0%10%20%30%40%50%60%70%80%90%
100%
CTAC Kids
CTAC Kids
1) intensity of trauma and accompanying horror in not too overwhelming
2) attach figures provides adequate ongoing comfort, communication, and protection regarding fear evoking experiences
Observation of visits: Caution: The ability to engage in play with children does not necessarily indicate that parent can provide comfort and soothing in times of child distress, anger, or noncompliance
Strange Situation for Young Children Under two years of age.
Marschak Intervention Method (Therapy Play)
Handout
Surrounded in Controversy due to the intensity and challenges of the continuum of insecure attachment.
Rewiring someone’s relational brain can take a lifetime
Psychoeducation about attachment, trauma, and its impact on not only to the child but to them as well.
Teaching caregivers attunement skills to respond not to the behaviors, but what is underneath that behavior
Integration of the left and right side of the brain
Multiple sensory based methods
Music,
dance,
rhythm,
touch,
story telling,
creating narratives
Trauma Focused Cognitive Behavioral Therapy
Real Life Heroes
ARC
Theraplay
1) Build/Rebuild healthy attachments between children and their traumatized parents
2) Creating a safe environment for the child that facilitates healthy recovery
1) Creating a safe and predictable environment by establishing rituals and routines.
1) Adults being in Control
2) Rules are defined for keeping everyone safe
3) Bedtime rituals
4) Objects of Affection
5) Daily Schedules
Basic safety and security a child is provided is the key to all developmental competencies including regulation of emotion, behavior, and relationships.
2. Increasing caregivers ability to manage the child’s intense affect
Ability to identify what one is feeling
Ability to connect these feelings to experience
Ability to read emotional cues of others
Build capacity to safely express emotions and emotional experiences
Ability to recognize and shift from emotional experiences
Ability to return to a comfortable state of arousal
3) Improve caregiver attunement so as the caregiver is responding to the child’s underlying affect and not behavioral manifestations
Teaching parents not to personalize
Teaching parents how to recognize their own triggers
Teaching parents how to absorb affect
4. Increase PRAISE of the child to facilitate the child’s identification with competencies not deficits.
Must consider an ecological approach that targets all three areas
Individual child
Family system
Larger system
Such children are likely to be frequently disconnected to their own relational experiences (not being aware of what they are doing during the intense affect dyregulationmoment.
Building or restoring efficacy
Fostering developmental competencies
Planning
Social skills
Impulse control
Building familial and systemic supports
Helping child gain mastery over their environment
What can you tell the child that he or she does that demonstrates this?
School success
Physical success
Relational success
Emotional regulation success
Create opportunities for child connection with peers and adults and community
Extracurricular school activities
Play groups
Church youth groups
Orchestrating relational opportunities
Build on child’s strengths to foster self esteem
Creating specific opportunities for success based on what you know the child does well
Encourage practice and learning from outcomes
Spending the times to talk about what happened
What went well, what didn’t
How come this may have happened?
How could there have been a different outcome
Interplay between refusal to seek out caregiver comfort and rejection of caregiver attempts and challenging behaviors often overwhelm resource parents
Observation of visits: Caution: The ability to engage in play with children does not necessarily indicate that parent can provide comfort and soothing in times of child distress, anger, or noncompliance
Resiliency is a product of the child’s interactions with the environment
Resiliency is a product of the balance between risk and protective factors. If balance tilts can lose resilience
Brain-stem
Diencephalon
Limbic
NeocortexAbstract ThoughtConcrete ThoughtExecutive FunctionAttachmentSexual BehaviorEmotional RegulationMotor RegulationMotivationArousalSleepBP / Heart RateRespiratory DriveBody TemperaturePerry 2006
All sensory input enters here
Brain-stem
Diencephalon
Limbic
Neocortex
Complexity Plasticity &Ease of change
Caregiver:
Impairment
Inconsistency
Unpredictability
Own history of unresolved trauma
Abandonment due to multiple placements, caregivers incarceration,
Child must deal with overwhelming experiences through primitive survival strategies
Aggression
Dissociation
Avoidance
Child cannot adequately develop emotional regulation skills because of overwhelming relational experiences and the lack of caregiver modeling
Child continues to rely on primitive coping strategies (Spinazzola, et. al, 2005) that often lead to impaired functioning